Provider Demographics
NPI:1073574943
Name:SCUDDAY, BRUCE ALLEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALLEN
Last Name:SCUDDAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1700 CURIE DR
Mailing Address - Street 2:SUITE #4000
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2905
Mailing Address - Country:US
Mailing Address - Phone:915-533-5151
Mailing Address - Fax:915-533-5187
Practice Address - Street 1:1700 CURIE DR
Practice Address - Street 2:SUITE #4000
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2905
Practice Address - Country:US
Practice Address - Phone:915-533-5151
Practice Address - Fax:915-533-5187
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1149213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089896701Medicaid
NM70286Medicaid
NM70286Medicaid
TX089896701Medicaid